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CONFERENCE REGISTRATION FORM 18th Annual National Health Benefits Conference & Expo (HBCE)

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February 3-4, 2009 Tampa Convention Center, Florida

Registration Fees:         EMPLOYER      COMMERCIAL**    1st Person                               $295                   $345** 2nd Person                               275                      325 3rd Person                                250                      295 4th Person                              FREE                   FREE ** For those who offer health products or related services to    employers, including consultants.

Notes:  Register early to guarantee entry - more attendees every year.  No penalty if you cancel before 1/20/09 - $50 after. Add $50 if you register after January 20, 2009.

Name & Title:__________________________________________________________________________________ Name & Title (2nd):______________________________________________________________________________ Company/Employer:_____________________________________________________________________________ Street:________________________________________________________________________________________ City:________________________________________State:__________Zip:________________________________ Phone:_____________________________________________Fax:_______________________________________ E-mail(s):_____________________________________________________________________________________

Please make CHECKS payable to: Health Benefits Conference & Expo Send to: 500 The Esplanade, Suite 205            Venice, FL  34285-1533 Phone:   941-484-1430 Fax:       941- 484-1410 (many complete            this form and FAX with payment            by credit card or send check later) E-mail:   info@HBCE.com _____    Please invoice/bill my employer.

Or pay by CREDIT CARD & mail or FAX to: 941- 484-1410 Credit Card (circle or check)   MC___  VISA___   AMEX___ Card No.__________________________________ Exp. Date______________Total $______________ Signature _________________________________ Name on Card______________________________

THANK YOU

TIN:  20-1571141

TAX DEDUCTIBILITY:  Expenses of training, including registration, lodging & meals, incurred to maintain or improve skills in your profession, may be tax deductible.  Consult your tax advisor.

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